PDF(Pubmed)
Abstract：
UNASSIGNED: Fibular hemimelia is the most common congenital long bone deficiency. It is often associated with femoral and tibial deficiencies which result in a clinically evident leg length discrepancy. The primary soft tissue concern is ACL/PCL deficiency. If treatment includes bony lengthening, joint stability is imperative to avoid complications. In this study, we detail a novel technique for long bone lengthening and ACL reconstruction in a single, cohesive surgery. This consolidates the need for multiple procedures and offers improved limb length symmetry and knee stability for this patient population. Clinical outcomes of pediatric patients with hemimelia who underwent either femoral or tibial lengthening with PRECICE® nail and concomitant ACL reconstruction are presented.
UNASSIGNED: After IRB approval, we identified five patients with complex fibular hemimelia who underwent ACL reconstruction and concomitant lengthening with at least two years of follow-up. Two patients (40%) presented with congenital short femur, and three (60%) with congenital short tibia. In each case, ACL reconstruction and either femoral or tibial guided growth via PRECICE® nail were performed. Operative techniques involving both soft tissue and bony methodology are described in detail.
UNASSIGNED: All patients had objective improvement in knee stability as assessed both intra and post operatively, as well as successful intermedullary lengthening without complications related to joint stability. Three patients had minor complications unrelated to joint stability that did not interfere with overall result.
UNASSIGNED: Fibular hemimelia associated with hypoplasia of bony and soft tissue structures can be successfully addressed with concomitant ligamentous reconstruction at the time of implantation of lengthening devices. This addresses knee instability and reduces both number of operative procedures and potential complications related to joint instability while pursuing bony lengthening. Level of Evidence: V.
UNASSIGNED: After IRB approval, we identified five patients with complex fibular hemimelia who underwent ACL reconstruction and concomitant lengthening with at least two years of follow-up. Two patients (40%) presented with congenital short femur, and three (60%) with congenital short tibia. In each case, ACL reconstruction and either femoral or tibial guided growth via PRECICE® nail were performed. Operative techniques involving both soft tissue and bony methodology are described in detail.
UNASSIGNED: All patients had objective improvement in knee stability as assessed both intra and post operatively, as well as successful intermedullary lengthening without complications related to joint stability. Three patients had minor complications unrelated to joint stability that did not interfere with overall result.
UNASSIGNED: Fibular hemimelia associated with hypoplasia of bony and soft tissue structures can be successfully addressed with concomitant ligamentous reconstruction at the time of implantation of lengthening devices. This addresses knee instability and reduces both number of operative procedures and potential complications related to joint instability while pursuing bony lengthening. Level of Evidence: V.
摘要：
■腓骨半位症是最常见的先天性长骨缺陷。它通常与股骨和胫骨缺陷有关，导致临床上明显的腿部长度差异。主要的软组织问题是ACL/PCL缺陷。如果治疗包括骨延长，关节稳定是避免并发症的当务之急。在这项研究中,我们详细介绍了一种用于长骨延长和ACL重建的新技术，有凝聚力的手术。这巩固了对多个程序的需求，并为该患者群体提供了改善的肢体长度对称性和膝盖稳定性。介绍了使用PRECICE®钉进行股骨或胫骨延长术并伴随ACL重建的儿童半球症患者的临床结果。
■经IRB批准，我们确定了5例复杂性腓骨半角症患者,他们接受了ACL重建术和同时延长术,并进行了至少2年的随访.两名患者（40％）表现为先天性股骨短，和三个（60％）先天性胫骨短。在每种情况下，通过PRECICE®钉进行ACL重建和股骨或胫骨引导生长。详细描述了涉及软组织和骨方法的手术技术。
■经评估，所有患者的膝关节稳定性均有客观改善，以及成功的髓间延长，没有与关节稳定性相关的并发症。三名患者出现了与关节稳定性无关的轻微并发症，但不会干扰总体结果。
■与骨和软组织结构发育不全相关的腓骨半位症可以在植入延长装置时通过同时进行韧带重建来成功解决。这解决了膝盖不稳定，并减少了手术次数和与关节不稳定相关的潜在并发症，同时追求骨延长。证据级别：V.
■经IRB批准，我们确定了5例复杂性腓骨半角症患者,他们接受了ACL重建术和同时延长术,并进行了至少2年的随访.两名患者（40％）表现为先天性股骨短，和三个（60％）先天性胫骨短。在每种情况下，通过PRECICE®钉进行ACL重建和股骨或胫骨引导生长。详细描述了涉及软组织和骨方法的手术技术。
■经评估，所有患者的膝关节稳定性均有客观改善，以及成功的髓间延长，没有与关节稳定性相关的并发症。三名患者出现了与关节稳定性无关的轻微并发症，但不会干扰总体结果。
■与骨和软组织结构发育不全相关的腓骨半位症可以在植入延长装置时通过同时进行韧带重建来成功解决。这解决了膝盖不稳定，并减少了手术次数和与关节不稳定相关的潜在并发症，同时追求骨延长。证据级别：V.
